“Altered metabolism is a universal property of most, if not all, cancer cells.”
The Warburg effect in tumor progression: Mitochondrial oxidative metabolism as an anti-metastasis mechanism, J Lu, et al, 2015
Epidemic of Awareness
There is a revolution in-progress in medicine. A revolution that is redefining the very nature of disease. What event has caused such a change? Technology has been introduced which can accurately and consistently measure chemical and genetically-based molecules existing in blood and tissue. In the last several years, the quantity of research in this field has expanded exponentially with thousands of articles published, thousands of molecules identified. Each molecule represents an agent, naturally produced by the body in response to another stimulus, another agent. The technology and abundance of research enabled, has provided a wealth of data and resulting conclusion from each study. Unfortunately, this new-found knowledge has also brought confusion and opportunity for abuse. Many drugs have been introduced which target a single agent (protein, gene, cell type, etc.) which have demonstrated short-term reversal of disease processes only to later introduce a much more aggressive, typically incurable, form of the disease or cancer. Statistically, the numbers of patients living with terminal cancers has increased, while the quality of life for these individuals has decreased, the cost of care has produced insurmountable burden to them, their families and society as whole. Does the patient have choice, when the alternative is an earlier death? In fact, the landscape is so poor, many patients choose death over an another drug, additional suffering from its side effects.
In spite of the thousands of research studies, the hundred’s of new drugs, accelerated FDA approvals, and 100s of billions of dollars in investment, today’s leadership in medicine must still admit that they are really no closer to cure for most, if not all cancers.
“Despite remarkable advances in pharmaceutical drug design, effective chemotherapy options for brain and nervous system cancers that demonstrate selective cytotoxicity remain a challenge in medicinal chemistry. A recent National Cancer Institute report stated, “over the last 30–40 years, the mortality rate for brain and other CNS cancers has remained largely unchanged.”[1] Current chemotherapeutic options are limited, and typically only provide 6–24 month survival rates.[2]”
Design, synthesis, and evaluation of curcumin-derived arylheptanoids
for glioblastoma and neuroblastoma cytotoxicity
Catherine A. Campos, Joseph B. Gianino, Barbara J. Bailey, Mary E. Baluyut,
Constanze Wiek, Helmut Hanenberg, Harlan E. Shannon, Karen E. Pollok,
and Brandon L. Ashfeld
Department of Chemistry and Biochemistry, Mike and Josie Harper Cancer
Research Institute, University of Notre Dame
Bioorganic and Medicinal Chemistry Letters, 2013
“The past decade has witnessed a dramatic increase in our knowledge on cancer on multiple scales leading to a host of potential drug targets and subsequent clinical trials. Yet the outcome for many cancers has not improved (1).”
Towards a Science of Tumor Forecasting for Clinical Oncology, Thomas E. Yankeelov, et al.,
Institute of Imaging Science, Department of Radiology and Radiological Sciences, Department of Biomedical Engineering, Department of Physics and Astronomy, Department of Cancer Biology, and Vanderbilt-Ingram Cancer Center, Vanderbilt University
Computer Science and Mathematics Division, Oak Ridge National Laboratory
Journal of Cancer Research, 2015
In 2000, an article was published which sought to define the most common traits of all cancers. Entitled, “The Hallmarks of Cancer,” the article attempted to outline and describe the key characteristics of most if not all cancers. In the article, the authors concluded that their were six common traits, hallmarks, of cancer. In 2011, however, the same authors published a revised, updated paper, entitled “Hallmarks of Cancer: The Next Generation.” Again, the authors were attempting to describe the key characteristics of cancer, but do so in light of recent discoveries in genetic research. In their article, new characteristics were introduced that were common to all cancers. They termed the new traits discovered to be “emerging hallmarks. These new “hallmarks” included characteristics of inflammation, changes in cell metabolism, avoiding immune response and recognition of the role of the tumor microenvironment. Today, these “emerging hallmarks” are now validated and accepted characteristics of all cancers. This is a revolution, a revolution of awareness, at least.
So what value is this revolution in our understanding of the nature of disease, of cancer? Is it redefining medicine? Redefining our concepts of disease? Can we expect to benefit from this new understanding of disease? If not, it is only then, an opportunity for a continuation of the failure of medicine that exists in its current state. If medical outcomes were defined by any other industry, by outcomes per dollars invested, the doors would have been closed years ago. Of course, medicine is exempt from responsibility regarding expectations of performance, they hold our very lives in their hands. We are presented with very low expectations and conditioned to be grateful for any small success (a small delay in the inevitable).
Altered Cell Metabolism – a characteristic of All Cancers!
Finally, medicine has accepted what was hypothesized over 80 years ago by Otto Warburg; cancer is a disease of altered cell metabolism. The metabolism is altered to function in an oxygen-deficient, stress environment, to become more self-sufficient by storing nutrients, by altering it behavior. The new metabolism is described as anaerobic glycolysis. The consequences consist of a cascading modification of cell functions which, in turn, participates in altering the cellular microvenvironment.